title: Costs and prolonged length of stay of central venous catheter-associated bloodstream infections (CVC BSI): a matched prospective cohort study.
abstract: OBJECTIVE
  Central venous catheter-associated bloodstream infections (CVC BSI) are a common and serious complication among critically ill patients on intensive care units (ICUs), but also result in a financial burden for the health care system. Our aim was to determine the additional costs and length of stay (LOS) of patients with ICU-acquired CVC BSI.
  
  
  METHODS
  We used the surveillance method of the German nosocomial infection surveillance system (Krankenhaus Infections Surveillance System, KISS) to find cases of CVC BSI. The associated costs of CVC BSI were estimated as true costs generated within our hospital. We used a matched cohort design, comparing patients with CVC BSI and patients without BSI. The study period was from January to December 2010. Patients were matched by age, sex, and Simplified Acute Physiology Score (SAPS). The LOS in the ICU of control patients needed to be at least as long as that of CVC BSI patients before the onset of CVC BSI.
  
  
  RESULTS
  We matched 40 CVC BSI patients to 40 patients without BSI. The median hospital costs for CVC BSI patients were significantly higher than for patients without BSI (60,445 € vs. 35,730 €; p = 0.006) and the CVC BSI patients stayed longer in the hospital than patients without CVC BSI (44 days vs. 30 days; p = 0.110). The median attributable costs per CVC BSI was 29,909 € (p = 0.006) and the median attributable LOS was 7 days (p = 0.006).
  
  
  CONCLUSIONS
  CVC BSI is associated with increased hospital costs and prolonged hospital stay. Hospital management should implement control measurements to keep the incidence of CVC BSI as low as possible.
authors.affiliation: Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité, University Medicine Berlin, Hindenburgdamm 27, 12203, Berlin, Germany, rasmus.leistner@charite.de.
authors.forename: R
authors.initials: R
authors.lastname: Leistner
authors.forename: E
authors.initials: E
authors.lastname: Hirsemann
authors.forename: A
authors.initials: A
authors.lastname: Bloch
authors.forename: P
authors.initials: P
authors.lastname: Gastmeier
authors.forename: C
authors.initials: C
authors.lastname: Geffers
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000191:economics* / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult